Providence is calling a Compliance Commercial Consultant who will:
Be responsible for handling various aspects of regulatory compliance activities for commercial health plan business (individual, employer group, and ancillary product lines)
Evaluate new and existing state and federal laws and regulations in order to advise internal customers and advance the health plan's interests
Represent the Regulatory Compliance, Risk Management, and Government Affairs Department in internal implementation processes related to the health plan's legal obligations and new business initiatives
Serve in a support role for the team leadership and as an internal subject matter expert to staff and leadership at PHP regarding regulatory requirements
Be responsible for analysis of legal obligations and complex regulatory reporting and filing requirements
Support PHP's legal and regulatory obligations as well as financial obligations to commercial Providence Health Plan customers
We welcome 100% remote work for residents of Southwest Washington and Oregon.
Responsible for required filings with state regulators ensuring health plan compliance, including requirements of licensure
Evaluates new and existing state and federal regulations in order to advance the health plan's positions and implement compliance obligations
Functions as liaison between PHP and state and federal regulator staff as tasked by team leadership
Provides regulatory interpretations to team leaders and management and staff at PHP
Represents Regulatory Compliance, Risk Management, and Government Affairs Department in internal and external implementation processes for the health plan's new business initiatives
Consults with internal and external legal counsel as needed to fulfill these duties
Provides orientation, training, and support to leadership and staff at PHP regarding regulatory compliance for commercial products
Collaborates with colleagues in the Regulatory Compliance, Risk Management, and Government Affairs department in a manner that fosters an effective working relationships and a positive work environment
Required qualifications for this position include:
Bachelor's Degree -OR- Associate's Degree and four years of related work experience
5 years relevant health plan, compliance and/or legal experience or experience in another regulated industry
5 years experience with two of the following: Process improvement, policy and procedure development, technical or legal writing, written customer communications
Preferred qualifications for this position include:
Our best-in-class benefits are uniquely designed to support you and your family in staying well, growing professionally and achieving financial security. We take care of you, so you can focus on delivering our Mission of caring for everyone, especially the most vulnerable in our communities.
At Providence, our strength lies in Our Promise of “Know me, care for me, ease my way.” Working at our family of organizations means that regardless of your role, we’ll walk alongside you in your career, supporting you so you can support others. We provide best-in-class benefits and we foster an inclusive workplace where diversity is valued, and everyone is essential, heard and respected. Together, our 120,000 caregivers (all employees) serve in over 50 hospitals, over 1,000 clinics and a full range of health and social services across Alaska, California, Montana, New Mexico, Oregon, Texas and Washington. As a comprehensive health care organization, we are serving more people, advancing best practices and continuing our more than 100-year tradition of serving the poor and vulnerable.
About the Team
Providence Shared Services is a service line within Providence that provides a variety of functional and system support services for our family of organizations across Alaska, California, Montana, New Mexico, Oregon, Texas and Washington. We are focused on supporting our Mission by delivering a robust foundation of services and sharing of specialized expertise.
We are committed to the principle that every workforce member has the right to work in surroundings that are free from all forms of unlawful discrimination and harassment.
We are committed to cultural diversity and equal employment for all individuals. It is our policy to recruit, hire, promote, compensate, transfer, train, retain, terminate, and make all other employment-related decisions without regard to race, color, religious creed (including religious dress and grooming practices), national origin (including certain language use restrictions), ancestry, disability (mental and physical including HIV and AIDS), medical condition (including cancer and genetic characteristics), genetic information, marital status, age, sex (which includes pregnancy, childbirth, breastfeeding and related medical conditions), gender, gender identity, gender expression, sexual orientation, genetic information, and military and veteran status or any other applicable legally protected status. We will also provide reasonable accommodation to known physical or mental limitations of an otherwise qualified caregiver or applicant for employment, unless the accommodation would impose undue hardship on the operation of our business.
We are a community where all people, regardless of differences, are welcome, secure, and valued. We value respect, appreciation, collaboration, diversity, and a shared commitment to serving our communities. We expect that all workforce members in our community will act in ways which reflect a commitment to and accountability for, racial and social justice and equality in the workplace. As such, we will maintain a workplace free of discrimination and harassment based on any applicable legally protected status. We also expect that all workforce members will maintain a positive workplace free from any unacceptable conduct which creates an intimidating, hostile, or offensive work environment.
Requsition ID: 127288
Company: Providence Jobs
Job Category: Member Services Enrollment & Billing
Job Function: Health Plans Services
Job Schedule: Full time
Job Shift: Day
Career Track: Business Professional
Department: 5018 COMPLI GOVERNMENTAL AFFAIRS OR REGION
Address: OR Beaverton 3601 SW Murray Blvd
Providence is proud to be an Equal Opportunity Employer. Providence does not discriminate on the basis of race, color, gender, disability, veteran, military status, religion, age, creed, national origin, sexual identity or expression, sexual orientation, marital status, genetic information, or any other basis prohibited by local, state, or federal law.